{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:32:23Z","timestamp":1792801943067,"version":"4.5.0"},"reference-count":52,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T00:00:00Z","timestamp":1689379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Higher valency pneumococcal conjugate vaccines (PCV15 and PCV20) have been developed to address the disease burden of current non-vaccine serotypes. This review describes the epidemiological characteristics of serotypes beyond PCV13 (serotypes 8, 10A, 11A, 12F, 15B\/C, 22F, and 33F; PCV20nonPCV13 serotypes). Peer-reviewed studies published between 1 January 2010 (the year PCV13 became available) and 18 August 2020 were systematically reviewed (PROSPERO number: CRD42021212875). Data describing serotype-specific outcomes on disease proportions, incidence, severity, and antimicrobial non-susceptibility were summarized for individual and aggregate PCV20nonPCV13 serotypes by age group and by type and duration of pediatric PCV immunization program. Of 1168 studies, 127 (11%) were included in the analysis. PCV20nonPCV13 serotypes accounted for 28% of invasive pneumococcal disease (IPD), although the most frequent serotypes differed between children (10A, 15B\/C) and adults (8, 12F, 22F). In children, serotype 15B\/C tended to be more frequently associated with pneumococcal meningitis and acute otitis media; in adults, serotype 8 was more frequently associated with pneumonia and serotype 12F with meningitis. Serotypes 10A and 15B\/C in children and 11A and 15B\/C in adults were often associated with severe IPD. Serotype 15B\/C was also among the most frequently identified penicillin\/macrolide non-susceptible PCV20nonPCV13 serotypes. These results could inform decision making about higher valency PCV choice and use.<\/jats:p>","DOI":"10.3390\/microorganisms11071816","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:41:05Z","timestamp":1689554465000},"page":"1816","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Systematic Literature Review of the Epidemiological Characteristics of Pneumococcal Disease Caused by the Additional Serotypes Covered by the 20-Valent Pneumococcal Conjugate Vaccine"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4410-6718","authenticated-orcid":false,"given":"Estelle","family":"M\u00e9roc","sequence":"first","affiliation":[{"name":"P95 Epidemiology & Pharmacovigilance, Koning Leopold III-laan 1, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2660-8730","authenticated-orcid":false,"given":"Mark A.","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Emerging Markets Medical Affairs, Vaccines, Pfizer, 23\u201325 Av. du Dr Lannelongue, 75014 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germaine","family":"Hanquet","sequence":"additional","affiliation":[{"name":"P95 Epidemiology & Pharmacovigilance, Koning Leopold III-laan 1, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1443-5174","authenticated-orcid":false,"given":"Mary P. E.","family":"Slack","sequence":"additional","affiliation":[{"name":"School of Medicine & Dentistry, Griffith University Gold Coast Campus, Parklands Drive, Southport, QLD 4222, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7266-551X","authenticated-orcid":false,"given":"Marc","family":"Baay","sequence":"additional","affiliation":[{"name":"P95 Epidemiology & Pharmacovigilance, Koning Leopold III-laan 1, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-2313","authenticated-orcid":false,"given":"Kyla","family":"Hayford","sequence":"additional","affiliation":[{"name":"Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford D.","family":"Gessner","sequence":"additional","affiliation":[{"name":"Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4538-6424","authenticated-orcid":false,"given":"Lindsay R.","family":"Grant","sequence":"additional","affiliation":[{"name":"Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Papadatou, I., Tzovara, I., and Licciardi, P.V. 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